Barriers to mental health treatment in Polish employer-based health plans: insurance limitations and policy gaps.

OBJECTIVES: The current employment market faces many challenges, both from the employers' perspective and that of employees. One of the key health challenges is employees' mental health. Poland has over 17.6 million of active workforce, but each year the number of sick leaves due to mental disorders and occupational burnout is rising, and so are the costs. This leads to lower incomes, higher utilization of medical services, higher spending on medications, and higher social transfers, impacting the country's economy and individuals' quality of living. This research aims to present the current market practice, gaps, and limitations in the coverage of mental health services available through employee medical plans, as well as to provide epidemiological characteristics of sick leave due to mental health issues in Poland. MATERIAL AND METHODS: This analysis included general terms and conditions of insurance companies providing employee medical plans (group health insurance) available on their websites. Mental health cover and exclusions of liability were analyzed using 6 different criteria. Epidemiological data on sick leaves (absenteeism) were derived from the annual reports published by the Polish Social Insurance Institution. RESULTS: All insurance companies introduce strong limitations on mental health cover. The gaps apply to the number of packages that cover consultations with psychologists and psychiatrists, as well as the number and type of visits. Most insurers cover no more than 4 visits with a psychologist and psychiatrist per year, excluding psychotherapy (with 1 exception). The main exclusions of liability include treatment of mental illnesses or behavioral disorders and treatment of addiction. There is no coverage for the costs of medications. CONCLUSIONS: The offer for mental health treatment through employee medical plans is strongly limited and does not cover the actual needs. Employees must seek treatment through the public sector or pay out of pocket for services with limited income during sick leave. Int J Occup Med Environ Health. 2025;38(6):654-63.